Quality Improvement Specialist II

🔥 13 hours ago

🌵 Arizona, Nevada – Remote

🌵 Arizona – Remote 🎰 Nevada – Remote

💵 $56.2k - $101k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Assist with daily operations and support within the Quality Improvement department • Manage the HEDIS project, including nurse assignments, plan timeline adherence, and vendor oversight for timeliness and quality • Assist with data collection, data entry, and report generation for QI initiatives • Support access and availability studies, HEDIS abstraction forms, medical records/site reviews, and member and physician satisfaction studies • Analyze data and write reports for committee discussion • Research and write provider newsletters and educational materials • Conduct interdepartmental inter-rater reliability audits • Design, run, and manage data review processes to ensure report accuracy and integrity • Implement process improvements to streamline departmental functions • Assist the Director, QI with regulatory agency and review organization audits • Perform other assigned duties • Comply with all policies and standards

🎯 Requirements

• Associate’s degree in related field or equivalent experience • 4+ years of data management experience with a health insurance organization • Experience in a position with accountability for report generation management or project management • Working knowledge of MS Office applications • Candidates must reside in Arizona or Nevada • Experience with Managed Care Organizations (MCO), Quality Management/Improvement, and HEDIS preferred • Experience in quality initiatives, including HEDIS project, study analysis, or NCQA standards, preferred

🏖️ Benefits

• Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off • Holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity